Vitamin D in schizophrenia: a clinical review

Chiang, Mathew; Natarajan, Radhika; Fan, Xiaoduo

doi:10.1136/eb-2015-102117

Cited by 69 publications

(41 citation statements)

References 62 publications

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“…Indeed, inadequate neurosteroid action of vitamin D on the brain, particularly during development, is related to the changes such as inflammatory and immunological disturbances, which are present in schizophrenia, too (49,50). Therefore, the cases of very low serum levels of 25(OH)D in our study probably point to patients with serious mental disorders that required the prescription of clozapine, the first line option for treatment-resistant psychotic features.…”

Section: Discussionmentioning

confidence: 72%

Vitamin D Deficiency and Associated Factors in Patients with Mental Disorders Treated in Routine Practice

Ristic

Živanović

Milovanovic

et al. 2017

J Nutr Sci Vitaminol

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SummaryThis research aimed to investigate factors associated with vitamin D deficiency and to provide data about its prevalence in patients suffering from different psychiatric illnesses. The study had a cross-sectional design and it included 220 patients of both genders, aged from 19-81 y, with a wide range of mental disorders (F00-F89), and treated in routine ambulatory and hospital practice. The researchers collected data from three sources: medical records, a study questionnaire and biochemical analysis of patients' serum samples (concentration of vitamin D measured as 25(OH)D, calcium, phosphorus, magnesium, sodium and potassium). Data were analyzed using descriptive statistics, methods for hypothesis testing and binary logistic regression, at the p#0.05 level. A total of 140 patients (64%) had a deficiency of vitamin D (,12 ng/mL), and 45 (20%) had inadequate vitamin D serum levels (12-20 ng/mL), while 35 (16%) had sufficient vitamin D serum concentrations (.20 ng/mL). Among variables related to demographics, life style habits, mental illness, comorbid disorders and drugs, two of them, female gender (odds ratio (OR)52.5, 95% confidence interval (CI)51.3-4.9, p50.006) and using clozapine (OR515.6, 95% CI 1.7-144.7, p50.02), were significantly associated with vitamin D deficiency. Physical activity (OR5 0.4, p50.02), exercising (OR50.2, 95% CI , p50.02) and offal in the diet (OR50.5, 95% CI 0.3-0.9, p50.03) significantly aggregated in the patients who had a 25(OH)D serum concentration above the deficiency cut-off level. Patients with mental disorders are at high risk for vitamin D deficiency, particularly females and clozapine users as well as those having no adequate physical activity or dietary habits.

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Section: Discussionmentioning

confidence: 72%

Vitamin D Deficiency and Associated Factors in Patients with Mental Disorders Treated in Routine Practice

Ristic

Živanović

Milovanovic

et al. 2017

J Nutr Sci Vitaminol

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“…Psychosis also has shared environmental risk factors with other autoimmune disorders, such as season‐of‐birth and latitude effects, which have been hypothetically related to neonatal vitamin D status …”

Section: Overlap Between Psychosis Autoimmune Disorders and Autoimmumentioning

confidence: 99%

Psychosis: an autoimmune disease?

et al. 2017

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Psychotic disorders are common and disabling. Overlaps in clinical course in addition to epidemiological and genetic associations raise the possibility that autoimmune mechanisms may underlie some psychoses, potentially offering novel therapeutic approaches. Several immune loci including the major histocompatibility complex and B-cell markers CD19 and CD20 achieve genome-wide significance in schizophrenia. Emerging evidence suggests a potential role via neurodevelopment in addition to classical immune pathways. Additionally, lymphocyte biology is increasingly investigated. Some reports note raised peripheral CD19 and reduced CD3 lymphocyte counts, with altered CD4 : CD8 ratios in acute psychosis. Also, post-mortem studies have found CD3 and CD20 lymphocyte infiltration in brain regions that are of functional relevance to psychosis. More specifically, the recent paradigm of neuronal surface antibody-mediated (NSAb) central nervous system disease provides an antigen-specific model linking adaptive autoimmunity to psychopathology. NSAbs bind extracellular epitopes of signalling molecules that are classically implicated in psychosis such as NMDA and GABA receptors. This interaction may cause circuit dysfunction leading to psychosis among other neurological features in patients with autoimmune encephalitis. The detection of these cases is crucial as autoimmune encephalitis is ameliorated by commonly available immunotherapies. Meanwhile, the prevalence and relevance of these antibodies in people with isolated psychotic disorders is an area of emerging scientific and clinical interest. Collaborative efforts to achieve larger sample sizes, comparison of assay platforms, and placebo-controlled randomized clinical trials are now needed to establish an autoimmune contribution to psychosis.

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“…Although its role in maintenance of calcium homeostasis and bone mineral density are well known (1, 2), its link with myriads of clinical conditions such as cardiovascular diseases, infection, vaso-occlusive crisis, diabetes, and mental disorders continues to generate research interests of public health importance (3–6). …”

Section: Introductionmentioning

confidence: 99%

Vitamin D Levels in Different Severity Groups of Schizophrenia

et al. 2017

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BackgroundVitamin D deficiency (VDD) continues to be associated with schizophrenia, but there is the dearth of information on the relationship between the severity of schizophrenia and plasma levels of vitamin D. This study, therefore, determined the plasma levels of vitamin D in different severity groups of schizophrenia.Materials and methodsPlasma level of vitamin D was determined in 60 patients with schizophrenia and 30 apparently healthy individuals who served as controls. Patients with schizophrenia were classified into mildly ill, moderately ill, markedly ill, and severely ill groups using the Positive and Negative Syndrome Scale (PANSS).ResultsThe mean level of vitamin D was significantly lower in patients with schizophrenia compared with the controls. Similarly, there was a significant association between VDD and schizophrenia. The mean plasma levels of vitamin D were not significantly different when the mildly, moderately, markedly, and severely ill groups were compared with one another and there was no significant correlation between vitamin D level and PANSS scores. Furthermore, patients on atypical antipsychotics had an insignificantly lower level of vitamin D compared with the patients on typical antipsychotics.ConclusionIt could be concluded from this study that patients with schizophrenia have low plasma vitamin D level which does not appear to be associated with the severity of schizophrenia and type of antipsychotics. Therefore, regular screening for vitamin D status of patients with schizophrenia is suggested in order to allow for the institution of appropriate clinical intervention when necessary.

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Vitamin D in schizophrenia: a clinical review

Cited by 69 publications

References 62 publications

Vitamin D Deficiency and Associated Factors in Patients with Mental Disorders Treated in Routine Practice

Vitamin D Deficiency and Associated Factors in Patients with Mental Disorders Treated in Routine Practice

Psychosis: an autoimmune disease?

Vitamin D Levels in Different Severity Groups of Schizophrenia

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